PIT PATTERN DIAGNOSIS FOR COLORECTAL POLYPS USING NARROW-BAND IMAGING WITH MAGNIFICATION ENDOSCOPY AND ACETIC-ACID ENHANCEMENT (WITH A VIDEO)

Abstract

Conventional white-light imaging is a fundamental modality for colonoscopy, while magnification endoscopy visualizes the superficial glandular microstructure that contributes to the qualitative diagnosis of colorectal polyps. Therefore, the Japanese medical guidelines recommend the combined use of both modalities for the diagnosis of colorectal polyps. Recently, narrow-band imaging with magnification endoscopy (NBIME) has been widely used owing to its clinical feasibility. Magnification chromoendoscopy using crystal violet (CV-MCE) visualizes the shape of a crypt opening (pit pattern) more clearly than NBIME. However, as CV-MCE is time consuming and potentially carcinogenic, it is likely to only be used for cases in which the diagnosis difficult using white-light imaging and NBIME. In addition to CV-MCE, NBIME with acetic-acid enhancement (A-NBIME) visualizes the pit pattern and is safer and quicker than CV-MCE. Furthermore, the pit pattern is gradually visualized using NBIME, which makes it easier to compare the endoscopic images captured by both modalities. Therefore, A-NBIME is a useful diagnostic modality in the clinical and academic field.